Provider Demographics
NPI:1538484290
Name:ARK ANGELS LLC
Entity Type:Organization
Organization Name:ARK ANGELS LLC
Other - Org Name:COMFORT KEEPERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:ACTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-525-6656
Mailing Address - Street 1:1515 MOCKINGBIRD LN
Mailing Address - Street 2:STE 515
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28209-3236
Mailing Address - Country:US
Mailing Address - Phone:704-525-6656
Mailing Address - Fax:704-525-6335
Practice Address - Street 1:1515 MOCKINGBIRD LN
Practice Address - Street 2:STE 515
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28209-3236
Practice Address - Country:US
Practice Address - Phone:704-525-6656
Practice Address - Fax:704-525-6335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-06
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3964253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care